The document summarizes the minutes from a Diversion First Stakeholders Group meeting on May 24, 2021. It includes an agenda for the meeting covering program updates, a presentation on the Marcus Alert system, and breakout group discussions. A key topic was the micropilots conducted to test co-response models between law enforcement and crisis clinicians. The meeting also provided an overview of the Marcus Alert legislation in Virginia which aims to establish protocols to divert behavioral health crises to community services through crisis call centers, mobile crisis teams, and law enforcement collaboration.

1. Diversion First Stakeholders Group Meeting
May 24, 2021

2. Welcome!
John C. Cook
Chairman, Diversion First
Stakeholders Group
2

3. Agenda
Welcome
John C. Cook, Chairman, Diversion First Stakeholders
Announcements
Program Updates
Presentation- Marcus Alert System
Breakout Groups
Brief Report Outs from Breakout Groups
Wrap Up
3

4. Judicial Center Complex
Diversion and Community Re-Entry Center
The Judicial Center Master plan includes a Diversion and Community
Re-Entry Center
As conceptualized, this Center would provide:
 Resources for those re-entering the community from jail
 Greater access to services that provide alternatives to arrest
 Integrated behavioral health and care coordination
 Resources for employment, healthcare, benefits and other services
necessary to keep individuals from recurring involvement with the
criminal justice system
 Housing location services, along with on-site housing options
Currently included in Phase 4 of the Master Plan
4

5. Diversion First 2020 Annual Report
5

6. Intercepts 0 and 1
The Sequential Intercept Model (SIM) is a framework
to inform community-based responses to the
involvement of people with behavioral health issues
in the criminal justice system
Intercept 0
 Connect individuals to treatment/supports before
there is a behavioral health crisis, or at the earliest
stage of interaction with the criminal justice system
Intercept 1
 Includes contact with law enforcement, as well as
emergency and crisis response
6

7. Merrifield
Crisis Response Center
Abbey May, Director, Emergency and Crisis Services, Community Services Board
7

8. Merrifield Crisis Response Center
8

9. Medical Assessment Program
Partnership with Neighborhood Health, a Federal
Qualified Health Center (FQHC) to provide onsite
services at the Merrifield Crisis Response Center
(MCRC) for individuals in need of medical clearance
for psychiatric hospitalization or crisis stabilization
admission
Launched in October 2020
220 served October 2020-April 2021
COVID testing
Client experience
9

10. Fire and Rescue
Transports
 Direct appropriate transports to
MCRC instead of emergency department
Low medical risk
Behavioral health crisis
Improve client experience
Reduce utilization of emergency
department
10

11. Crisis Response
Abbey May, Director, Emergency and Crisis Services
Redic Morris, Strategic Planning Manager, Department of Public Safety Communications
James Krause, Captain, Fairfax County Police Department
11

12. Crisis Response
 Board Matter directing staff to review the public safety
response system to instances where behavioral health is
the principal reason for the call.
 Reviewed national models to explore options for
programs in Fairfax
 Consideration of evolving Marcus Alert legislation
Provide the right intervention, at the right time, by the
right person
12

13. Lessons Learned
 Jurisdictions that have successfully implemented a primary response to
behavioral health 911 calls do not have a single program, but a network of
programs, based on the needs of their community
 Variety of successful models (i.e., clinicians embedded in 911 dispatch
centers, Co-Responder Teams with clinicians, law enforcement, EMTs, peer
supports; clinicians embedded in police departments)
 The jurisdictions consulted all have services/programs for identifying and
providing outreach to frequent utilizers of the public safety system, and
follow up after crisis response
 Models tend to evolve over time, and some jurisdictions’ initial
implementation started on a small scale and expanded over time.
 Implementation of programs requires a significant investment of resources
13

14. Micropilot Part 1
• Community Services Board (CSB) clinicians rotated through the
Department of Public Safety Communications (DPSC) for 8 weeks
• Received an orientation to DPSC operations and systems and spent time
with dispatchers and Police and Fire and Rescue Liaisons
• Listened to a sampling of potential behavioral health calls and identified
calls that could potentially receive a behavioral health response (i.e.,
possible co-response, possible de-escalation over the phone, case
management/linkage to other behavioral health services)
• 82% of the calls reviewed by clinicians indicated that a behavioral health/co-
response would have been beneficial
• An additional 15% indicated that additional behavioral health
involvement/resources would have been beneficial
14

15. Micropilot Part 1- Lessons Learned
• Calls are complex, and it may not be immediately clear whether there is a
behavioral health component
• Given the nature of 9-1-1 calls, the DPSC triage process requires quick
decision-making
• In contrast, the process for Mobile Crisis Unit calls allows for more
research prior to a response
• Based on sampling of calls reviewed by CSB staff, a significant percentage
could have benefited from a co-response
• Micropilot enhanced communication and collaboration; participants
agreed that it would be helpful to have a long-term behavioral health
presence at DPSC
15

16. Micropilot Part 2
After a thorough review of models and consideration of the best
starting place for Fairfax County, started a Micropilot focusing on a
law enforcement officer/crisis intervention specialist co-response
approach
Why this approach?
• Safety of community and team members
• Does not currently exist in our crisis continuum
• Enhanced communication and collaboration
• Aligned with Marcus Alert, and neighboring jurisdictions
Several other jurisdictions across the country successfully use this
co-response approach
16

17. Micropilot Part 2
Crisis Intervention Specialist from the Mobile Crisis Unit (MCU) paired
with CIT trained Police Officer
• Utilized one of the two existing Mobile Crisis Units (MCUs)
• 3 days a week, 8-hour shifts (Wednesday-Friday; 12:00-8:00pm)
• Fire and Rescue able to request co-response (MCU or MCU/PD)
• Weekly meeting with field team
CSB Crisis Intervention Specialist at DPSC
• Mirrored co-response shifts
• Assisted with identifying potential calls for co-response and/or provide
DPSC with behavioral health resources
• Researched calls to assist team
17

18. Micropilot Part 2 Goals
• Learn more about calls that would be appropriate for a behavioral health
response
• Gather data for co-response events
• Link community members to needed behavioral health services
• Help inform next steps, to include a long-term crisis response approach
• Assess logistics and resource needs
• Is this approach feasible long-term?
• Are there other partners that should be included to expand the
scope?
• What would it take to scale up to a 24/7/365 countywide system?
• Ensure we continue to be aligned with Marcus Alert implementation
18

19. Next Steps
 Timeframe and scope of micropilots limited
by existing resources
 Continued collaboration with partners
 Analyzing data from micropilot and
determining resources needed to continue
 Actively monitoring the protocols required
through the Marcus Alert
19

20. Marcus Alert and Other Coming
Crisis Service Changes
Jean Post, Director, Regional Projects Office
Redic Morris, Strategic Planning Manager, Department of Public Safety Communications
Daryl Washington, Executive Director, Community Services Board
20

21. A CRISIS SERVICE SYSTEM IN TRANSFORMATION
21
Ensure that Virginia provides a therapeutic, health-
focused response to behavioral health emergencies
Marcus Alert
Regional
Crisis Call
Center
Regional
Mobile Crisis
Anticipated Outcomes:
 Improve the individuals in crisis access and linkage to community services
 Earlier crisis response within the continuum of care to deescalate before an individual’s needs rise
to the level of deeper criminal justice involvement
 Enhancement of community-based crisis services with focus on warm handoffs to community
service providers should decrease the need for temporary detention orders

22. Why was the
Marcus Alert
Created?
The Marcus-David Peters Act is a comprehensive
approach to ensuring that Virginia provides a
therapeutic, health focused approach to
behavioral health emergencies
 Largely the result of advocacy by the family of
Marcus-David Peters , who was fatally shot in
the midst of a mental health crisis
Legislation was introduced in the 2020 Special
Session of the General Assembly
 Signed by Governor Northam in December
2020
22

23. What is the Marcus Alert System
 The development and implementation of protocols to divert
behavioral health crises to the behavioral health system
 Creation of additional mobile crisis or community care teams
to respond 24/7
 A public service campaign
 A voluntary database made available to the 9-1-1 alert system
23

24. Marcus Alert Timeline
24
July 1, 2021
• DBHDS to develop
plan, with diverse
stakeholder input,
for establishment of
Marcus Alert and
submit to General
Assembly.
• Establish a voluntary
database (DCJS)
available to 911
December 1, 2021
• Establish and fully
implement 5 Marcus
alert programs and
community care or
mobile crisis teams.
In Northern Virginia,
Prince William will
establish the 1st
Marcus Alert
Program.
• Initiate a public
campaign to
promote the Marcus
Alert and create
awareness.
July 1, 2022
• Every locality shall have
established and
implemented local protocols
for both the diversion of
certain 911 calls to crisis call
centers and the participation
of law enforcement in the
Marcus alert system.
• Establish 5 additional Marcus
alert system programs and
community care or mobile
crisis teams and add
additional programs on an
annual basis until all localities
have Marcus Alert. In
Northern Virginia, Fairfax will
establish the 2nd Marcus
Alert program.
July 1, 2026
• All areas must have
Marcus Alert
established and fully
implemented by this
date.

25. Marcus Alert
Statewide Stakeholders Group
The Department of Behavioral Health and Developmental
Services, in collaboration with the Department of Criminal
Justice Services and law-enforcement, mental health,
behavioral health, developmental services, emergency
management, brain injury, and racial equity stakeholders
must develop a written plan by July 1, 2021
• Began meeting in January 2021, with diverse statewide
group membership
• Various workgroups for different aspects of the law
25

26. Marcus Alert- Four Level Framework
26
Level 1- Routine
Level 2- Moderate
Level 3- Urgent
Level 4- Emergent

27. Regional Crisis Call Centers and 9-8-8
• Federal legislation passed in 2020 allows the National
Suicide Prevention Lifeline (NSPL) to be accessible by
dialing 9-8-8 and will be accessible to all localities July
2022
• In the Commonwealth, the Regional Crisis Call Centers
will be designated as 9-8-8 Crisis Hotline Centers
• Regional Crisis Call Centers are expected to launch prior
to 9-8-8, and will eventually be a part of the 9-8-8 system
• Goal is to have one number to call for behavioral health
crises in our community
27

28. Regional Crisis Call Center Scope
28
Centralized
number with
telephonic, text,
and chat options
for individuals
experiencing a
crisis
24/7/365 access
Staffed by clinically
trained professional,
paraprofessionals,
volunteers, and
licensed staff, to
deliver services
through immediate
emergency
interventions
Capacity to deescalate
crises over phone, linkage
to regional and local
resources, warm handoffs
to community-based
providers or hospital
services, information and
referral services and
manage dispatch of
mobile crisis teams

29. Examples of Current Mobile Crisis Response
29
• Mobile Crisis Unit
• 703-573-5679; crisis response to community calls (2 units)
• Community Response Team
• Outreach and care coordination for frequent utilizers of public
safety services; referred through public safety system
Local Mobile
Crisis Response
• REACH (Regional Education and Assessment Crisis
Response)
• 855-897-8278); respond when the individual has developmental needs
• CR2 (Children’s Regional Crisis Response)
• 844-627-4747; will respond when a child has a behavioral health need.
• This program is expected to expand services to adults in the fall of FY22
Regional Mobile
Crisis Response

30. Mobile Crisis
and
Community
Care Teams
(as defined by
Marcus Alert
legislation)
30
Mobile Crisis Teams
• A team of one or more behavioral health professionals, and may
include a registered peer recovery specialist or a family support
partner. A law-enforcement officer shall not be a member of a
mobile crisis team, but law enforcement may provide backup
support as needed to a mobile crisis team
Community Care Teams
• A team of behavioral health professionals, and may include registered
peer recovery specialists and/or EMTs
• Also refers to co-responder teams comprised of behavioral health
clinicians and law enforcement
Teams could be deployed by the Regional Call Center
Localities will define which approach (or approaches) will
work best for their communities

31. Next
Steps
31
Feedback to stateside stakeholder group
State level plan due July 1, 2021
Five initial jurisdictions in December 2021
Five additional jurisdictions in 2022
Anticipated local planning efforts late
2021- early 2022

32. Breakout Sessions
Questions:
 Based on what you heard in the Marcus Alert presentation, what
do you think should be considered in planning for the local
implementation of the Marcus Alert?
 As a Diversion First Stakeholder, what aspects of the Marcus
Alert matter to you most?
 What does successful Marcus Alert implementation look like to
you?
Breakout sessions will convene for 15 minutes
You will be placed into breakout sessions automatically
Each group will have a moderator and a note taker
32

33. THEMES FROM BREAKOUT SESSIONS
REPORT OUT
33

34. Questions and
Comments
34

35. DiversionFirst@fairfaxcounty.gov
35

36. Additional slides
36

37. 37
Merrifield Crisis Response Center (MCRC)
Service Encounters by Type – January 2020 – April 2021
52 47 44
28 38
50 42 46 49
67
51
36
48 58 68
56
133
154
145
147
142
137
127
134
108
136
138
114
137 117
144
122
340
368
305
148
163
212 210
234
243
257
234
266
283
235
262 265
0
50
100
150
200
250
300
350
400
Jan'20 Feb'20 Mar'20 Apr'20 May'20 Jun'20 Jul'20 Aug'20 Sep'20 Oct'20 Nov'20 Dec'20 Jan'21 Feb'21 Mar'21 Apr'21
LEO Involved - Voluntary Transports LEO Involved - Emergency Custody Order Transports
General Emergency Services (non-law enforcement involved) Diverted from potential arrest

38. Diversion First
Data Snapshot
January 1, 2021 –
March 31, 2021
38

39. Diversion First Housing
Permanent Supportive Housing for 30
individuals in single occupancy units
Priority: Homeless individuals; unstably
housed Jail Diversion population
Contractor is New Hope Housing; and CSB
offers case management, psychiatric
services, and management of referrals
39

40. Diversion First Housing
2020 Outcomes
34 individuals served in 2020
94% had no psychiatric hospitalizations
74% did not require CSB Emergency Services
85% of people remained engaged with CSB
 94% have maintained housing
Over 50% less expensive than jail
40